Krafchow v. Dongbu Insurance Co., Ltd. Consolidated With Case No. CAAP-21-0000517.

525 P.3d 697, 152 Haw. 248
CourtHawaii Intermediate Court of Appeals
DecidedFebruary 17, 2023
DocketCAAP-21-0000513
StatusPublished

This text of 525 P.3d 697 (Krafchow v. Dongbu Insurance Co., Ltd. Consolidated With Case No. CAAP-21-0000517.) is published on Counsel Stack Legal Research, covering Hawaii Intermediate Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Krafchow v. Dongbu Insurance Co., Ltd. Consolidated With Case No. CAAP-21-0000517., 525 P.3d 697, 152 Haw. 248 (hawapp 2023).

Opinion

FOR PUBLICATION IN WEST'S HAWAI#I REPORTS AND PACIFIC REPORTER

Electronically Filed Intermediate Court of Appeals CAAP-XX-XXXXXXX 17-FEB-2023 08:30 AM Dkt. 115 OP

IN THE INTERMEDIATE COURT OF APPEALS

OF THE STATE OF HAWAI#I

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EDMOND KRAFCHOW and KATHLEEN KRAFCHOW, Plaintiffs-Appellees, v. DONGBU INSURANCE CO., LTD., nka DB INSURANCE CO., LTD., JOHN MULLEN & CO., INC., Defendants-Appellants, and JOHN DOES 1-10, JANE DOES 1-10, and DOE ENTITIES 1-10, Defendants

NO. CAAP-XX-XXXXXXX

APPEAL FROM THE CIRCUIT COURT OF THE SECOND CIRCUIT (CIVIL NO. 2CC191000266)

EDMOND KRAFCHOW and KATHLEEN KRAFCHOW, Plaintiffs-Appellees, v. DONGBU INSURANCE CO., LTD., nka DB INSURANCE CO., LTD., JOHN MULLEN & CO., INC., Defendants-Appellants, and JOHN DOES 1-10, JANE DOES 1-10, and DOE ENTITIES 1-10, Defendants

APPEAL FROM THE CIRCUIT COURT OF THE SECOND CIRCUIT (CIVIL NO. 2CC191000266)

FEBRUARY 17, 2023

GINOZA, CHIEF JUDGE, HIRAOKA AND WADSWORTH, JJ. FOR PUBLICATION IN WEST'S HAWAI#I REPORTS AND PACIFIC REPORTER

OPINION OF THE COURT BY HIRAOKA, J.

These consolidated appeals arise from first-party insurance claims1 made by Plaintiffs-Appellees Edmund Krafchow and Kathleen Krafchow (collectively, the Krafchows) under insurance policies issued by Defendant-Appellant Dongbu Insurance Co., Ltd. (now known as DB Insurance Co., Ltd.). We must decide whether the appraisers and umpire who were to appraise "the amount of loss" had the power to decide what amount was owed by Dongbu to the Krafchows under the insurance policies. We hold they did not. They were to decide the amount of the Krafchows' loss irrespective of insurance coverage, not the amount of covered loss. Accordingly, we vacate (1) the "Order Granting Plaintiffs' Motion to Confirm Appraisal Summary and Awards" entered on July 26, 2021; (2) the "Amended Order Denying Defendants' Motion to Vacate and/or Modify Three Appraisal Awards or, in the Alternate, to Stay, and Reconfirming the Appraisal Awards" entered on June 13, 2022; and (3) the "Amended Order Denying Defendants' Motion to Vacate and/or Modify Three Appraisal Awards and Reconfirming Appraisal Awards" entered on June 14, 2022.2

BACKGROUND AND PROCEDURAL HISTORY

The Krafchows owned real property on the island of Maui. There were three structures on the property: the Villa; the Cottage; and the Garage. The structures were insured under separate insurance policies issued by Dongbu to the Krafchows. A homeowners policy covered the Villa. The Cottage and the Garage were covered by dwelling fire policies. The structures and their contents were damaged because of a wildfire. The Krafchows made insurance claims for their

1 A "first-party claim" is made under one's own insurance policy "for losses suffered by the insured." Best Place, Inc. v. Penn Am. Ins. Co., 82 Hawai#i 120, 124 n.4, 920 P.2d 334, 338 n.4 (1996). 2 The Honorable Kelsey T. Kawano presided.

2 FOR PUBLICATION IN WEST'S HAWAI#I REPORTS AND PACIFIC REPORTER

loss. Dongbu tendered over $300,000 to the Krafchows (under reservations of rights)3 pending preparation of "final settlement figures[.]" Dongbu also raised issues about coverage and limits of liability, and asked the Krafchows for additional information about their claims. The parties disagreed on the amount of the Krafchows' loss (among other things). The homeowners and dwelling fire policies contained substantially identical appraisal provisions:

Appraisal

If you and we fail to agree on the amount of loss, either may demand an appraisal of the loss. In this event, each party will choose a competent and impartial appraiser within 20 days after receiving a written request from the other. The two appraisers will choose an umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a court of record in the state where the ["residence premises"/Described Location] is located. The appraisers will separately set the amount of loss. If the appraisers submit a written report of an agreement to us, the amount agreed upon will be the amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of loss.

Each party will: 1. Pay its own appraiser; and

2. Bear the other expenses of the appraisal and umpire equally.

(Bold italics added.) The Krafchows invoked the appraisal provisions of the insurance policies, but Dongbu did not name an appraiser. The Krafchows then sued Dongbu and its claims adjuster, Defendant- Appellant John Mullen & Co., Inc. (collectively, DB). The

3 A reservation of rights "is a notice by the insurer to the insured that the insurer . . . is not waiving any defenses it may have under the [insurance] policy." First Ins. Co. of Haw. v. State, 66 Haw. 413, 422, 665 P.2d 648, 654 (1983) (original ellipsis omitted) (first quoting Crawford v. Ranger Ins. Co., 653 F.2d 1248, 1252 (9th Cir. 1981); and then citing 7C J. Appleman, Insurance Law & Practice § 4694 (Berdal 1979)).

3 FOR PUBLICATION IN WEST'S HAWAI#I REPORTS AND PACIFIC REPORTER

complaint alleged that Dongbu breached the insurance policies by failing to participate in the appraisal process.4 Dongbu's answer asserted these affirmative defenses:

38. This action is barred by the terms and conditions in the subject policies. . . . . 40. Coverage under the subject policies is barred in whole or in part by the terms, exclusions, conditions, and limitations contained or incorporated in such policy, including any and all endorsements. . . . . 42. [The Krafchows]' claims for additional damages are barred to the extent [their] claims are for losses or damage that were not covered or excluded under the Policy.

. . . .

57. To the extent that [the Krafchows] breached or failed to comply with the terms and conditions of the subject policies, [they] are barred from recovery. . . . .

58. To the extent that [the Krafchows], or someone acting on [their] behalf, has [sic] concealed, misrepresented or negligently failed to disclose material facts in their applications and/or claims for the purpose of inducing [Dongbu] to pay benefits, any claims for coverage under such policy are barred.

The Krafchows filed a motion to compel appraisals. DB opposed the motion. DB argued it was premature to appraise the amount of loss because coverage issues had not been resolved. The Krafchows' reply memorandum stated:

To the extent that [DB], who have already paid out over $300,000 in covered losses to the KRAFCHOWS, believes there is information which would preclude coverage, that is a question which is separate from appraising the value of the loss. The appraisal of the claim only establishes the value

4 The complaint also alleged that DB: breached the implied covenant of good faith and fair dealing; breached a fiduciary duty to the Krafchows; intentionally or negligently inflicted emotional distress upon the Krafchows; committed unfair and deceptive acts and practices in violation of Hawaii Revised Statutes (HRS) § 480-2; negligently failed to adjust the Krafchows' claims; and committed consumer fraud elder abuse in violation of HRS § 480- 13.5. The circuit court stayed proceedings on those claims pending the disposition of these appeals.

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Bluebook (online)
525 P.3d 697, 152 Haw. 248, Counsel Stack Legal Research, https://law.counselstack.com/opinion/krafchow-v-dongbu-insurance-co-ltd-consolidated-with-case-no-hawapp-2023.